Why Do I Keep Getting Bloody Noses? Understanding and Preventing Recurrent Nosebleeds

Nosebleeds, also known medically as epistaxis, are a surprisingly common condition, affecting a significant portion of the population at some point in their lives. Experiencing a bloody nose can be alarming, but it’s important to understand that in most cases, they are not serious and can be managed effectively, especially at home. However, if you find yourself frequently asking, “Why Do I Keep Getting Bloody Noses?”, it’s crucial to explore the potential causes, understand how to manage them, and know when to seek professional medical advice.

Close-up of a person pinching their nose to stop a nosebleed

Common Causes of Frequent Nosebleeds

Several factors can contribute to recurrent nosebleeds. Understanding these can help you identify potential triggers and take preventive measures.

Dry Air and Low Humidity

One of the most prevalent reasons for nosebleeds is dry air. Whether it’s the dry climate you live in, or the dry indoor air during winter months due to heating systems, low humidity can dry out the nasal membranes. This dryness can cause the delicate lining of your nose to become cracked and more susceptible to bleeding, even from minor irritation like rubbing or blowing your nose.

Nasal Irritation and Allergies

Irritation to the nasal passages is another common culprit. This can stem from several sources:

Nasal Sprays: Overuse of decongestant nasal sprays, especially those containing steroids or antihistamines, can irritate and dry out the nasal lining, increasing the likelihood of nosebleeds.
Allergies and Sinus Infections: Conditions that cause inflammation and irritation in the nasal passages, such as allergies (allergic rhinitis) and sinus infections (sinusitis), can also lead to more frequent nosebleeds. The increased nasal discharge and frequent nose blowing associated with these conditions can further irritate the nasal lining.
Nose Picking: This common habit is a significant cause of nosebleeds, particularly in children and even adults. The delicate blood vessels in the nose are easily injured by picking.

Medications

Certain medications can increase your susceptibility to nosebleeds:

Anticoagulants: Blood-thinning medications like aspirin, warfarin, and other anticoagulants are designed to reduce blood clotting. While essential for preventing strokes and heart attacks in some individuals, they can also make you bleed more easily, including from the nose. If you are on these medications and experiencing frequent nosebleeds, it is important to discuss this with your healthcare provider.

Less Common but Notable Causes

While less frequent, other medical conditions and factors can contribute to recurrent nosebleeds:

High Blood Pressure (Hypertension): Elevated blood pressure can sometimes be a factor in nosebleeds, although it’s not usually the primary cause of recurrent nosebleeds. It’s more likely to prolong a nosebleed once it has started.
Deviated Septum: A deviated septum, where the wall between your nasal passages is displaced, can cause dryness and increased airflow in one nostril, making it more prone to bleeding.
Hereditary Hemorrhagic Telangiectasia (HHT): This is a genetic condition that causes abnormal blood vessel formation, which can lead to frequent nosebleeds, often starting in childhood.
Tumors: Rarely, tumors in the nasal passages or sinuses can cause nosebleeds. However, nosebleeds are almost never the sole symptom of a tumor, and other symptoms would typically be present.

What To Do When You Get a Nosebleed: Step-by-Step Guide

Knowing how to properly manage a nosebleed at home is essential. Here’s a detailed guide based on medical recommendations:

Stay Calm: It’s crucial to remain calm. Anxiety can sometimes worsen the bleeding. Take slow, deep breaths to help relax.
Lean Forward: Sit upright and lean slightly forward. This posture helps prevent you from swallowing blood, which can irritate your stomach and cause nausea or vomiting. If there is blood in your mouth, spit it out into a sink or tissue.
Use a Decongestant Nasal Spray (Optional but Helpful): Applying a decongestant nasal spray like oxymetazoline (Afrin) can help constrict the blood vessels in your nose and reduce bleeding. Spray 3 times into the bleeding nostril.
Pinch Your Nose: Using your thumb and index finger, firmly pinch the soft lower part of your nose, below the bony bridge. Make sure to pinch the soft part where cartilage is, closing off the nostrils.
Pinch Continuously for 10 Minutes (Timed): This is a critical step. Maintain constant pressure for a full 10 minutes. Use a clock or timer to ensure accuracy. Resist the urge to release pressure to check if the bleeding has stopped before the 10 minutes are up, as this can disrupt the clotting process.
Check and Repeat if Necessary: After 10 minutes, release the pressure. Check if the bleeding has stopped. If it continues to bleed, soak a cotton ball with the decongestant nasal spray and gently place it into the bleeding nostril. Pinch again for another 10 minutes, timed.
Avoid Nose Blowing and Strenuous Activity: Once the bleeding has stopped, avoid blowing your nose or engaging in strenuous activities for at least 24-48 hours. This allows the blood vessels to fully heal and reduces the risk of re-bleeding.
Monitor Your Blood Pressure (If Possible): If you have a blood pressure monitor at home, check your blood pressure. While high blood pressure is usually not the cause of a nosebleed, elevated blood pressure can make it harder to stop. If your blood pressure is significantly high and you are experiencing other symptoms like headache or dizziness, seek medical advice.

Nosebleed “Don’ts”: What to Avoid

Knowing what not to do during a nosebleed is equally important:

Don’t Pack with Tissues or Tampons: Avoid stuffing tissues, cotton balls, or tampons high up into your nasal cavity. This is ineffective and can actually irritate the nasal lining further, potentially worsening the bleeding or leading to infection. A cotton ball soaked with nasal spray, placed just inside the nostril, is acceptable if needed for the second 10-minute pinching attempt.
Don’t Tilt Your Head Back: Tilting your head back is a common misconception. This is not recommended because it causes blood to drain down the back of your throat. Swallowing blood can lead to nausea, vomiting, and can make it harder to assess how much you are bleeding.
Don’t Engage in Strenuous Activity: Avoid heavy lifting, vigorous exercise, and even strenuous household chores for a few days after a nosebleed. Increased physical activity can raise blood pressure and potentially restart the bleeding.

When to Seek Emergency Medical Attention

While most nosebleeds are manageable at home, certain situations require immediate medical attention. Go to the emergency room or seek urgent medical care if you experience any of the following:

Unstoppable Bleeding: If the nosebleed does not stop after 30 minutes of continuous, correctly applied pressure, you need to seek medical help.
Heavy Bleeding: If the bleeding is very heavy, such as blood gushing out or flowing rapidly down the back of your throat and out of your nose, this requires immediate evaluation.
Bleeding with Other Symptoms: Nosebleeds accompanied by other symptoms like chest pain, lightheadedness, rapid heart rate, or a sudden, severe headache, especially with very high blood pressure, could indicate a more serious underlying condition and warrant emergency care.
Nosebleed After Injury: If your nosebleed is the result of a significant injury to your head or nose, seek medical attention to rule out fractures or other complications.
Frequent Nosebleeds: If you are experiencing nosebleeds more than once a week, or more than 4-6 times a month, despite following home care tips, it’s important to consult with your doctor to determine the underlying cause and receive appropriate management.
If You Take Blood Thinners: Individuals who take anticoagulant medications and experience frequent or severe nosebleeds should contact their doctor promptly, as their medication dosage may need adjustment.

Preventing Frequent Nosebleeds: Proactive Measures

If you are prone to frequent nosebleeds, incorporating these preventive measures into your routine can be beneficial:

Use a Humidifier: Especially during dry winter months, using a humidifier in your bedroom can add moisture to the air and help prevent your nasal passages from drying out.
Saline Nasal Sprays or Gels: Regular use of over-the-counter saline nasal sprays or gels can help keep your nasal passages moist and prevent dryness. Use them as directed, especially before bed and upon waking.
Avoid Nose Picking: Make a conscious effort to avoid nose picking. Keep fingernails trimmed to minimize injury if you do touch your nose.
Manage Allergies: If allergies are a trigger, work with your doctor to manage your allergy symptoms effectively, which may include antihistamines or nasal steroid sprays (used as prescribed by a doctor to avoid overuse and rebound effects).
Stay Hydrated: Drinking plenty of fluids helps keep all mucous membranes, including those in your nose, hydrated.
Lubricate Nasal Passages: In very dry climates, consider applying a thin layer of petroleum jelly or a nasal moisturizing gel inside your nostrils, especially at night, to help keep them moist.

By understanding the causes of frequent nosebleeds and taking appropriate preventive and management steps, you can significantly reduce their occurrence and impact on your life. If you remain concerned about why you keep getting bloody noses, or if they are frequent or severe, always seek advice from a healthcare professional to rule out any underlying medical conditions and receive personalized guidance.